Saturday, October 15, 2011

Diet for a healthy breastfeeding mom

Many new moms wonder what breastfeeding means for their diet. You probably don't need to make any major changes to what you eat or drink while you're nursing, though there are a few important considerations to keep in mind:

Eat a well-balanced diet for your health


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One of the wonders of breast milk is that it can meet your baby's nutritional needs even when you're not eating perfectly. (However, if you eat a diet that's too low in calories or that relies on one food group at the exclusion of others, this could affect the quality and quantity of your milk.)
Just because your baby won't be harmed by occasional dietary lapses on your part doesn't mean that you won't suffer, though. When you don't get the nutrients you need from your diet, your body will draw on its reserves, which can eventually become depleted. Also, you need strength and stamina to meet the physical demands of caring for a new baby.
Many moms feel extra hungry while breastfeeding, which makes sense – your body is working around the clock to make breast milk for your baby. Eating small meals with healthy snacks in between (the way you may have done during pregnancy) is a good way to keep your hunger in check and your energy level high.

Don't count calories

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There's no one-size-fits-all answer to how many calories you need to consume as a nursing mom. As a general guideline, most women who are breastfeeding will need about 200 to 500 calories more than moms who aren't – which would mean a minimum of 2,000 to 2,700 calories per day.
Instead of counting calories, follow your hunger as a guide to how much you need to eat.
The exact amount will depend on a number of individual factors, such as your weight, how much exercise you get, how your metabolism works, and how much you're breastfeeding.

Aim for slow and steady weight loss

While some new moms find the weight just seems to fall off while they're breastfeeding, others don't lose much. It all depends on your body, your food choices, your activity level, and your metabolism.
The best plan: Lose your pregnancy weight gradually. Count on taking ten months to a year to return to your pre-pregnancy weight.
And don't even think about trying to lose weight by dieting until two months after your baby is born. A reduced-calorie diet in the first couple of months could zap your energy and hurt your milk supply.
Most women can safely lose 1.5 pounds per week by combining a healthy diet with moderate exercise. Losing weight more rapidly than this can pose a danger to your baby because rapid weight loss releases toxins that are normally stored in your body fat into the bloodstream – and into your milk.
A sudden, large drop in your calorie intake can affect your milk supply – so don't do any one-day diets for quick weight loss! If you're losing more than 1.5 pounds a week after the first six weeks, you need to take in more calories.

Include a variety of healthy foods

Variety and balance are key to a healthy diet. A balanced diet – which means eating a mix of carbohydrates, protein, and fat at meals – will keep you feeling full longer and supply the nutrients your body needs. Complex carbs like whole grains and cereals and fresh fruits and vegetables not only provide more nutrition than processed starches and sugars, they provide longer-lasting energy.
Variety across all food groups is important so you can get all the vitamins you and your baby need over time. So mix it up – try to eat something today that you didn't eat yesterday.

Choose good fats

When it comes to fat, think mono- and polyunsaturated fats – "healthy fats" like canola oil, olive oil, and fatty fish like salmon, as well as avocado, olives, nuts, and seeds. Limit saturated fats and avoid trans fats, both of which are considered unhealthy. They show up in high-fat meats, whole milk, tropical oils (such as palm kernel and coconut), butter, and lard. Saturated fats and trans fats are both listed on the nutrition facts label.
In addition to being bad for your diet, your intake of these unhealthy fats can alter the fat composition of your breast milk and aren't good for your baby's health. They can decrease the production of omega-3s, long-chain polyunsaturated fats that are important for infant growth and development.
While we don't know the long-term effects of unhealthy fats on infant cardiovascular health, we do know that in adults they've been shown to negatively affect heart health by raising levels of LDL (bad cholesterol), lowering HDL (good cholesterol), and increasing signs of inflammation as well as boosting the risk of heart attack and death from heart disease.

Take extra steps to avoid contaminants

It's a good idea to try to minimize your exposure to contaminants in your food (and your environment) while you're nursing. Pesticides and insecticides and other chemicals that you ingest can make their way to your breast milk. Although research is ongoing, we know that environmental chemicals could have an impact on your baby's long-term health. Here are some tips for limiting your exposure:
  • Eat a variety of foods. If you eat large quantities of one food – and it happens to be high in pesticides – your intake of pesticides will be higher than if that food is one of many you eat.
  • Know which fruits and vegetables are highest in pesticides and choose organic options or wash them very well or peel them. The "dirty dozen" that tested highest for pesticides as of 2010, according to the Environmental Working Group, were celery, peaches, strawberries, apples, blueberries, nectarines, bell peppers, spinach, cherries, kale/collard greens, potatoes, and imported grapes. The fruits and vegetables that tested lowest in pesticide residues were onions, avocado, sweet corn, pineapple, mangos, sweet peas, asparagus, kiwi, cabbage, eggplant, cantaloupe, watermelon, grapefruit, sweet potato, and honeydew melon.
  • Choose produce that's in season in your area, and purchase local produce when you can. Produce that travels long distances often has more pesticides.
  • Choose lean meats, and remove the skin and extra fat before cooking. Chemicals are stored in fat.
  • Consider drinking filtered water while breastfeeding. While the EPA requires that all tap water meet certain standards, small amounts of many chemicals are found in tap water.

Eat fish - but be picky

It's important to eat a variety of sources of protein while you're nursing – including fish. The American Heart Association recommends fish for a heart-healthy diet.
Some fish (especially cold water fish) also contain DHA and EPA, omega-3 fats that play an important role in brain and eye development that continues during your baby's first year. (Your baby will get these omega-3s from your breast milk.)
Not only does DHA help your baby, but it helps you too. One study found that moms who have lower breast milk levels of DHA, as well as lower seafood consumption, are more likely to develop postpartum depression.
Eat up to 12 ounces of most types of fish and seafood per week, including salmon, shrimp, lake trout, tilapia, catfish, crab, pollack, and scallops. However, some types of fish contain contaminants that can be harmful to pregnant and nursing women and children.
The Environmental Protection Agency and U.S. Department of Agriculture advise not eating four specific types of fish because they contain high levels of mercury: shark, swordfish, king mackerel, and tilefish. Solid white or albacore tuna tends to be higher in mercury than other types of canned tuna. If you eat solid white or albacore tuna, limit your intake to 6 ounces per week.
Other experts and advocacy groups are even more cautious, expanding the list of fish to avoid. Read more about eating fish when you're breastfeeding.

Go easy on the alcohol

If you time it right, an occasional drink probably won't cause your breastfeeding baby any harm, but in general you may want to hold off on drinking alcohol while you're breastfeeding. Alcohol does enter your breast milk, and having as little as one drink may affect your milk letdown reflex.
Studies show that babies consume less milk in the four hours after Mom consumes an alcoholic beverage. Babies may become drowsy and fall asleep more quickly after their breastfeeding mom drinks alcohol, but they also sleep for a shorter amount of time. (And of course heavy drinking will render you unable to safely care for your baby.)

If you're going to enjoy an occasional alcoholic beverage, keep in mind that it takes two to three hours for your body to eliminate the alcohol in one serving of beer or wine. Specific time frames depend on your size and how much you drink, of course, but the more you drink, the longer it takes – which means that you might want to time that toast for right after a feeding session.
Alcohol isn't stored in breast milk – instead, the level increases and decreases just as it does in your bloodstream – so "pumping and dumping" (using a breast pump to empty your breasts and then throwing out the collected milk) serves no purpose.
Drink water with your alcoholic drink, and eat before or while you drink, to help lower the amount of alcohol in your blood and your milk.

Drink plenty of water and limit caffeine

When you're breastfeeding, your body needs about 16 cups of total fluid a day (this includes fluid within the foods you eat, like fruits and vegetables). There's no need to keep a tally of your liquid intake, though. A good rule of thumb is to drink to thirst – that is, drink whenever you feel the need. If your urine is light colored, it's a good sign that you're well hydrated.
Speaking of fluids, it's okay to have your morning cup of coffee while breastfeeding if you like, but don't overdo it. A small amount of caffeine winds up in your breast milk. It can accumulate in your baby's system because he can't easily break down and excrete it.
Most experts suggest that nursing moms limit their consumption of caffeine (including coffee, tea, soft drinks, energy drinks, chocolate, and coffee ice cream) to no more than 300 mg per day, which is about as much as you'd get in a 12-ounce cup of coffee. Check out our caffeine chart to see how much caffeine is in popular beverages and foods.

Consider the flavors of what you eat and drink

Most nursing moms can eat a wide variety of foods while nursing – including spicy foods – without any objection from their baby. In fact, some experts suggest that babies enjoy a variety of flavors in their breast milk. Eating your favorite foods while you're nursing gives your baby a "taste" of your diet and may help him be more accepting of different foods once he starts eating solids.
But some moms swear that certain foods – like broccoli, cabbage, Brussels sprouts, dairy products, chocolate, citrus, garlic, or chili pepper – make their breastfed baby gassy or irritable. If your baby seems consistently uncomfortable after you eat a particular food, then by all means avoid it to see if your baby is happier.
In rare instances, your baby may be allergic to something you've eaten. If this is the case, you may see a reaction on his skin (rash or hives), in his breathing (wheezing or congestion), or in his stools (green or mucousy).

Keep taking your vitamins

It's a good idea to continue taking your prenatal vitamin while you're breastfeeding – at least for the first month or so. After that, you can switch to a regular multivitamin and mineral supplement or stay on your prenatal vitamin, depending on your individual needs. (You can discuss this with your healthcare provider at your first postpartum visit.)
A supplement doesn't take the place of a well-balanced diet, but it can provide some extra insurance, especially on those days when taking care of your new baby keeps you from eating as well as you'd like.
In addition to your prenatal vitamin or multivitamin, consider the following supplements:
Calcium: While your prenatal vitamin or multivitamin may have small amounts of calcium, you'll need some supplemental calcium if you're not eating at least three daily servings of calcium-rich foods (like milk and other dairy products, canned fish, or calcium-fortified foods like cereals, juices, soy and rice beverages, and breads).
The recommended dose for women before, during, and after pregnancy is 1,000 milligrams (mg) daily. Don't exceed 2,500 mg daily from all sources. Exceeding this safe upper limit can lead to kidney stones, hypercalcemia, and renal insufficiency syndrome. It can also interfere with your body's absorption of iron, magnesium, phosphorus, and zinc.
Vitamin D: Vitamin D is important for bone growth and overall health. It helps your body absorb calcium, and research suggests it may also reduce the risk of osteoporosis, high blood pressure, cancer, diabetes, and several autoimmune diseases.
Sun exposure helps your body produce vitamin D, but many women don't get enough sun (especially in the winter and with the use of sunscreen) to make adequate amounts – and experts feel the small amount found in food might not be enough. The best way to know whether you've been getting enough vitamin D is to have your blood tested.
While you're breastfeeding, the National Academy of Sciences recommends that you receive 200 IU (5 micrograms) of vitamin D daily. The Academy also states that the 400 IU contained in many postnatal vitamin supplements is not excessive. (In fact, many experts believe these recommendations are low, and the Academy is in the process of reviewing its vitamin D guidelines. Bruce Hollis, professor of pediatrics at the Medical University of South Carolina, who has researched vitamin D needs, recommends that lactating women take a supplement of 6,000 IU of vitamin D daily, for example.)
By the way, because breast milk doesn't supply an adequate amount of vitamin D, the American Academy of Pediatrics recommends that breastfed babies (either exclusively breastfed or those drinking less than 17 ounces of formula daily) receive a supplement of 200 IU (5 micrograms) of vitamin D each day too. Talk to your baby's doctor about a vitamin D supplement.
Vitamin D is important for bone development and the prevention of rickets in children. Experts think that getting enough vitamin D in childhood may also help prevent the development of certain conditions, like osteoarthritis, later in life.
DHA: The DHA content of your breast milk depends on your diet, particularly on whether you eat fish. So if your diet doesn't regularly contain a few servings of cold water fish every week, or other foods containing DHA (like specialty eggs containing DHA or other DHA-fortified foods), you might consider a supplement.
The Society for the Study of Fatty Acids and Lipids (a group of experts who deal with the health effects of dietary fats) recommends 200 mg of DHA per day during pregnancy and lactation.

Daily food and meal plans for breastfeeding moms

Chart of daily food group servings for breastfeeding moms.
Sample meal plans for breastfeeding moms.
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